Associations between Folate and Vitamin B12 Levels and Inflammatory Bowel Disease: A Meta-Analysis

Nutrients. 2017 Apr 13;9(4):382. doi: 10.3390/nu9040382.

Abstract

Background: Inflammatory bowel disease (IBD) patients may be at risk of vitamin B12 and folate insufficiencies, as these micronutrients are absorbed in the small intestine, which is affected by IBD. However, a consensus has not been reached on the association between IBD and serum folate and vitamin B12 concentrations.

Methods: In this study, a comprehensive search of multiple databases was performed to identify studies focused on the association between IBD and serum folate and vitamin B12 concentrations. Studies that compared serum folate and vitamin B12 concentrations between IBD and control patients were selected for inclusion in the meta-analysis.

Results: The main outcome was the mean difference in serum folate and vitamin B12 concentrations between IBD and control patients. Our findings indicated that the average serum folate concentration in IBD patients was significantly lower than that in control patients, whereas the mean serum vitamin B12 concentration did not differ between IBD patients and controls. In addition, the average serum folate concentration in patients with ulcerative colitis (UC) but not Crohn's disease (CD) was significantly lower than that in controls. This meta-analysis identified a significant relationship between low serum folate concentration and IBD.

Conclusions: Our findings suggest IBD may be linked with folate deficiency, although the results do not indicate causation. Thus, providing supplements of folate and vitamin B12 to IBD patients may improve their nutritional status and prevent other diseases.

Keywords: folate; inflammatory bowel disease; meta-analysis; nutrition; vitamin B12.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / immunology
  • Colitis, Ulcerative / metabolism
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / blood
  • Crohn Disease / immunology
  • Crohn Disease / metabolism
  • Crohn Disease / physiopathology
  • Dietary Supplements
  • Folic Acid / blood*
  • Folic Acid / metabolism
  • Folic Acid / therapeutic use
  • Folic Acid Deficiency / diet therapy
  • Folic Acid Deficiency / etiology*
  • Folic Acid Deficiency / prevention & control
  • Humans
  • Inflammatory Bowel Diseases / blood
  • Inflammatory Bowel Diseases / immunology
  • Inflammatory Bowel Diseases / metabolism
  • Inflammatory Bowel Diseases / physiopathology*
  • Intestinal Absorption
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / metabolism
  • Nutritional Status*
  • Vitamin B 12 / blood*
  • Vitamin B 12 / metabolism
  • Vitamin B 12 / therapeutic use
  • Vitamin B 12 Deficiency / diet therapy
  • Vitamin B 12 Deficiency / etiology*
  • Vitamin B 12 Deficiency / prevention & control

Substances

  • Folic Acid
  • Vitamin B 12